Transoral Submandibular Ganglion Neurectomy

Abstract

Transoral submandibular neurectomy is an attractive addition to the armamentarium of surgical options for the treatment of medically intractable sialorrhea. Further study in selected patients would need to be performed to demonstrate clinical feasibility.

Identification of cranial nerve ganglia using sectioned images and three-dimensional models of a cadaver

“…The length, width, and height of submandibular ganglion were 2.66 mm, 1.74 mm, and 3.63 mm respectively. The submandibular ganglion was found in the lingual nerve tract on the posterior aspect of the mylohyoid muscle, similar to that shown in another study [ 16 ]. The lingual nerve was tracked in a reverse manner.…”

“…Kim, et al was found in the lingual nerve tract on the posterior aspect of the mylohyoid muscle, similar to that shown in another study [16]. The lingual nerve was tracked in a reverse manner.…”

“…The first step was to identify all 12 pairs of the ganglia of the cranial nerves: the ciliary ganglion, trigeminal ganglion, pterygopalatine ganglion, otic ganglion, submandibular ganglion, geniculate ganglion, vestibular ganglion, spiral ganglion, superior and inferior glossopharyngeal ganglia, and superior and inferior vagal ganglia (Table 1) [12][13][14][15][16][17][18][19][20][21][22][23]. For this, sectioned images of the brainstem were examined to determine the origins of the cranial nerves (Fig.…”

“…To treat sialorrhea, the submandibular ganglion can be selected for injection of botulinum toxin A or surgical removal [16].…”

Feasibility of endoscopic submandibular ganglion neurectomy for drooling

“…Spock et al sought to manage sialorrhea via transoral submandibular neurectomy; the authors studied the feasibility of the technique employing cadavers . The procedure was attractive in that it was minimally invasive, highly selective, and feasible.…”